“Wait! You mean the pelvic floor is my vagina?”
I remember when I finally discovered where my pelvic floor actually was, and I’m pretty embarrassed to admit that I was in my thirties and had experienced two pregnancies.
I know that I’m not alone in this misunderstanding of the pelvic floor and/or its function. Maybe some of you have heard people talk about it and know that it’s important but don’t necessarily understand why it’s crucial.
I’m going to give you the down and dirty of the PF (pelvic floor). However, there is so much more complexity and depth to this topic, so if you have more specific questions, please consult a women’s health/pelvic floor physical therapist or a provider that specializes in women’s health.
Where/What is the PF?
Without getting too scientific, here is some basic anatomy. The PF is a group of muscles that sits within the pelvis. Think of it as a sling or trampoline holding up the organs of your abdomen. Besides that, it is also responsible for bladder, bowel, and sexual function. Yes, the vagina is one of the three openings that run through this group of muscles.
Why is the Pelvic Floor Important?
Some may refer to it as the “floor to the core” because it is a key player in our central stability system.
According to Women’s Health Physical Therapist, Dr. Kierra Larsen, PT, DPT, the pelvic floor works in coordination with our diaphragm, the deepest layer of our abdominal muscles (transverse abdominis), and our spinal stabilizing muscles (multifidi) to provide core stability. Every time we inhale and exhale, our pelvic floor muscles are working to accommodate the change in intra-abdominal pressure.
When the pressure increases (inhaling), it pushes everything downward, causing the PF to descend and relax. And when we exhale the PF contracts and lifts. There are many other factors beyond our breathing that impact this pressure, such as movement, positioning of our ribcage and pelvis, lifting, pregnancy, and tension.
Besides influencing the pressure inside the abdomen, pregnancy has a significant impact on the PF before, during, and after delivery.
Dr. Julie Peterson, PT, DPT, Board Certified Women’s Health Clinical Specialist, states that pregnancy can cause a circumferential stretch of up to 248% on the PF during vaginal delivery. Although this is a normal part of childbirth, the PF musculature needs attention following birth.
Issues and Dysfunctions
It’s important to understand that pelvic floor dysfunction does not necessarily mean that the muscles are weak, and you just need to strengthen it by doing 100 Kegels every day. It’s usually not that simple. Many different causes can lead to the PF not functioning the way that it should.
One of the most common symptoms of PF dysfunction is incontinence, which is any kind of urine or fecal leakage. We may joke about “sneeze-peeing” or having to change our undies after jumping on the trampoline with our kids. But this is not just a typical symptom of motherhood or of getting older that we should just tolerate. There is also no need to feel embarrassed or ashamed about these symptoms because YOU ARE NOT ALONE!
A less common issue is pelvic organ prolapse, which is the downward descent of the pelvic organs towards the vaginal opening. Symptoms may include feelings of pressure or heaviness like something is falling out of you, pain with sex, or a visible bulge. There are varying degrees of prolapse and symptoms that each woman may experience. These symptoms are usually intermittent and can be improved with treatment and management.
There are various ways to manage symptoms and improve the function of the PF. The most crucial step is to get an assessment from a women’s health/pelvic floor physical therapist. They will be able to evaluate the PF’s function and establish a treatment plan that will set you on a path towards improved service and wellness. It is especially important to get assessed when amid postpartum recovery. However, even if you are many years out from your last baby and are still experiencing symptoms, don’t allow these issues to persist, especially if they are taking a toll on your mental and physical health.
No matter what stage of life you are in (pre-pregnancy, childbearing, middle-aged, or post-menopausal), it’s fundamental for you as a woman to understand the pelvic floor and the potential issues related to it. However, it’s vital that you don’t lose hope when discovering that your body is no longer meeting the demands of daily living and/or your fitness goals.